This invention relates to medical and diagnostic devices and, more particularly, to apparatus and methods for measuring biological functions and physical disorders in humans.
Nearly one quarter of all fall prevention, dizziness and balance disorder patients suffer from a peripheral vestibular disorder called benign paroxysmal positional vertigo (BPPV), which is treatable with xe2x80x9crepositioning therapy.xe2x80x9d A far greater percentage of balance disorder patients have central problems, or both central and peripheral problems. Central vestibular disorders usually affect the vestibular nerve, the brain stem or the brain and require longer, more-indepth treatments. Presbyastasis, which is an age-related loss of vestibular function, is often the cause of central vestibular disorders in the majority of elderly patients. Other patients can acquire central vestibular disorders as a secondary pathology caused from a primary event or condition such as a stroke, vascular disease, toxicity, a neuromuscular disorder, an auto-immune disease, an inflammatory response, Parkinson""s disease or a head injury. Treatment of vestibular disorders that occur as a result of any of these primary events or conditions normally involves extensive physical therapy to bring about either resolution of the primary pathology or central compensation and substitution for the patient. Most patients with vestibular disorders require approximately seven to ten hours of physical therapy, but medical necessity often mandates more prolonged care.
Most patients that have vestibular disorders are first seen by a primary care physician, who evaluates the patient""s medical history and examines the patient. If the physician determines that the patient is a candidate for vestibular disorder therapy, the patient is referred to a specialist who also evaluates the patient and prescribes an appropriate treatment regimen.
Typical treatment regimens include a home-based, self-directed therapy component, which involves exercises that patients are to perform several times each day in regimens lasting over a week to ten days, after which the patient returns for another evaluation. The home-based exercises usually involve eye and head movements and other exercises that are designed to improve motor skills, posture and overall balance. If patients do their home-based exercises, they normally enjoy at least some measure of improvement, which allows them to progress into more advanced forms of exercise. The results of the home-based exercise and the gradual progression through increasingly advanced exercise regimens provide patients with cumulative physical benefits, with the goal being to provide the patient with substantially curative or maximum compensation. During this home-based process, which usually lasts two to three months, patients must periodically visit their specialist for progress evaluations.
Patients who diligently prosecute their customized or individualized home-based exercises achieve curative or maximum compensation more efficiently and faster than those who fail to do their prescribed exercises. Historically, studies have shown that patients neglect their exercises because of lack of motivation, because they find the exercises boring and unpleasant or because they either forget how to do them or that they do them incorrectly. Because patients are not monitored on a regular or daily basis throughout their periods of home-based exercise, specialists and therapists and physicians have no way of knowing whether their patients are prosecuting their exercises until the patients return for follow-up evaluations. As a result, many patients who are prescribed home-based exercises do not improve at acceptable rates of progression, which virtually always leads to more prolonged and expensive treatment. For most vestibular disorder patients, current home-based therapeutic regimens are, therefore, inefficient, inadequate and expensive.
Thus, there is a need for improved apparatus and methods for providing and managing therapeutic and evaluative treatment to vestibular disorder patients and to others that utilizes an interactive computer network and associated networked therapeutic components, which allow therapists, specialists, physicians and patients to interact on a regular and ongoing basis throughout periods of home-based therapeutic and evaluative regimens.
The above problems and others are at least partially solved and the above purposes and others realized in new and improved apparatus, systems and methods for treating and evaluating physical disorders or conditions, for recording measurable responses to at least one of audible and visual stimuli and commands and instructions, and for prosecuting treatment, therapeutic and evaluative regimens over a networked computer environment. In a preferred embodiment, the invention is comprised of a networked computer architecture that includes a potentially vast number of networked central and local clients. Each local client is equipped with apparatus for providing stimuli and for collecting reaction data in response thereto. The stimuli are designed to elicit patient responses such as head and eye movements and other measurable patient functions or movements that provide information about physical conditions and disorders. The reaction data are expressed as sensible indicia of the patient responses, namely, graphs, charts, numbers, figures, characters, etc.
The network includes a data structure that is accessible by local clients for storing reaction data and by central clients for accessing and interacting with the data. The network is implemented over a generalized or localized networked environment, and the data structure is accessible by the central and local clients over a privately- or publicly-accessible site, such as a privately- or publicly-accessible web site in the environment of the Internet. The apparatus is generally comprised of a unit that is adapted and arranged to provide the stimuli and to collect reaction data, and an associated and interactive, computer-implemented software program that is designed to govern therapeutic and evaluative regimens. The apparatus may further include a verbal command structure for facilitating verbal command interaction between the unit and the software program, and an associated microphone for facilitating verbal command interaction with the verbal command structure.
The local clients are for patients and they are remote from the central clients, which are administered by therapists, specialists, physicians or other authorized clinical or medical personnel. Because the central clients can access the stored reaction data, patient progress during the course of home-based therapeutic and evaluative regimens can be monitored and managed at the central clients. Because the invention is implemented in a networked computer environment, therapists, specialists and physicians and other authorized clinical personnel can communicate with patients by way of conventional electronic mail systems and by way of patient electronic documents, which house patient reaction data. In this regard, local clients have access to the data structure for not only storing reaction data into their electronic documents, but also accessing important information periodically provided from their therapists, specialists, doctors and other authorized clinical personnel.
Consistent with the foregoing, the invention also contemplates associated networked architectures and methods for prosecuting and managing therapeutic and evaluative regimens over a networked computer environment.